New Delhi: Amid a raging debate over banning of Electronic Nicotine Delivery Systems (ENDS) in the country, including e-cigarettes and flavoured hookah, more than 3,000 users of these devices have written to Prime Minister Narendra Modi, requesting him to legalise them.
In their petition, they claimed their health has improved significantly after they switched to vaping from smoking conventional cigarettes. “I am 51 and have successfully quit a 20-year habit of smoking over 40 cigarettes a day with the help of vaping, also known as as e-cigarettes. I have regained stamina, my heart condition is better and there is no smoker’s cough. There are thousands like me whose lives have been positively impacted,” said Jagannath Sarangapani, a professional from Hyderabad.
Sarangapani, who initiated the petition to counter the misinformation surrounding ENDS, said smoking is among the toughest habits to give up, with almost every smoker trying to quit but failing and stressed that they need more options to wean away from deadly cigarettes and ENDS are now the most effective means of doing so.
“A ban will force me back into smoking,” he added. In August last year, the Union Health Ministry issued an advisory to all states and UTs to stop manufacture, sale and import of ENDS after the Delhi High Court took strong exception to the Centre’s delay in coming up with appropriate measures to tackle the “new emerging threat” of e-cigarettes.
The advisory was subsequently challenged in Delhi High Court which ruled it to be non-binding on states and government bodies. However, 13 states in India – Punjab, Karnataka, Kerala, Bihar, Uttar Pradesh, Jammu Kashmir, Himachal Pradesh, Tamil Nadu, Maharashtra, Puducherry, Jharkhand and Mizoram – have already banned use and sale of e-cigarettes, Vape and E-Hookah.
Professor Rajesh Sharan from North-Eastern Hill University in Shillong, who recently published a meta-analysis of 229 studies on ENDS, said, “Within the limits of available information, our study indicates that these devices pose minimal health and safety concerns when compared to conventional cigarettes.
“Our study establishes that new generation ENDS may serve as an efficient means of meeting the nicotine demand of a person addicted to smoking, without the grave health consequences of conventional cigarettes. Rational policies are required to extend the benefits of ENDS to smokers, while preventing their misuse, especially by adolescents and non-smokers.”
A major year-long clinical trial into e-cigarette use published in peer-reviewed New England Journal of Medicine in January found that ENDS are twice as effective as traditional nicotine replacement therapies (NRTs) such as gums and patches in helping smokers quit.
According to market research agency Euromonitor, over 40 million smokers across the world have switched to ENDS in less than a decade. Dr Rohan Sequeira, cardio-metabolic physician at Jaslok Hospital in Mumbai, said authorities should understand vaping is much less harmful than smoking. A number of countries have done research and found the toxicological profile to contain significantly lower harmful substances than in cigarette smoke.
“The so-called dangers of ENDS are grossly exaggerated and misrepresented. E-cigarettes should be embraced as another effective NRT and should be legalised and regulated instead of imposing a ban,” Sequeria said. Harm reduction advocate and director of Association of Vapers India Samrat Chowdhery said the Indian government is pushing for a ban on vaping while the world’s 65 most advanced nations such as the US, 28 EU countries including the UK, along with Canada and New Zealand have embraced e-cigarettes.
A ban will deprive our country’s 12 crore smokers of an effective means to reduce tobacco harm while ensuring continued revenue for the tobacco industry by killing off competition to cigarettes that cause nearly 10 lakh annual deaths in India. “The government should put the lives of people before industry profits,” Chowdhery said.
“Teen uptake is a problem across risk behaviours, from alcohol use to underage driving, and most significantly with smoking as nine out of 10 current smokers began when they were minors. This issue needs to be tackled through sound regulation, but it should not be as an excuse to deny millions of citizens a pathway to avoid tobacco-related mortality and morbidity,” he stated.
The government action against e-cigarettes has also faced resistance from some NGOs. The Information Technology ministry in January proposed to ban information related to ENDS on online platforms. Over 30 civil society and industry organisations, including Amnesty, Internet Freedom Foundation, FICCI and COAI, opposed the amendment stating the ban would be arbitrary, unjustified and in violation of constitutional laws.
However, a group of doctors, students and civil society organisations urged the Prime Minister to enforce a ban on ENDS before it becomes an “epidemic in India”, especially among the youth. A sub-committee group constituted by the ministry, on health effects of ENDS, considered 251 studies/reports and concluded that there is evidence to prove that ENDS and its variants, are harmful to users.
This committee of doctors from AIIMS, NCDIR and public health experts have concluded that ENDS are as harmful as any another tobacco product in terms of causing premature deaths and morbidity. According to the committee, there is no evidence to show that they are less harmful, safe and helpful towards cessation efforts. The medical communities across the globe have also questioned the acceptance of ENDS as a harm reduction or tobacco cessation strategy.